生活质量评分对慢性阻塞性肺疾病患者个性化治疗的评估

Evaluation of Individuation Therapy with Quality of Life for Chronic Obstructive Pulmonary Disease Patients

目的探讨个性化治疗对慢性阻塞性肺疾病(COPD)患者的治疗效果,并应用生活质量评分进行评估。方法选取2006年1—12月于北京安贞医院呼吸内科门诊就诊的COPD患者173例,其中治疗组86例,对照组87例。对照组给予一般治疗,治疗组在对照组基础上通过针对每位患者的疾病教育、管理、康复、心理治疗等实现个性化治疗。分别在治疗前和治疗3个月后对患者进行肺功能检查及生活质量问卷调查(普适性问卷选用诺丁汉健康调查问卷,疾病特殊问卷选用西雅图阻塞性肺疾病问卷),并记录患者治疗期间COPD急性发作情况。结果两个生活质量问卷的内部一致性系数分别为0.85、0.77。两个生活质量问卷的结构效度分析结果显示其存在不同程度的统计学相关性(P<0.01)。治疗组治疗前后的生活质量评分比较,差异均有统计学意义(P<0.05);对照组治疗前后的生活质量评分比较,差异均无统计学意义(P>0.05)。治疗组治疗前后的肺功能比较,差异无统计学意义(P>0.05);对照组治疗前后的肺功能比较,差异亦无统计学意义(P>0.05)。结论个性化治疗可以改善COPD患者的生活质量。

Objective To investigate the effect of individuation therapy on the patients with chronic obstructive pulmonary disease （COPD）, and to evaluate it with scores in quality of life. Methods Total 173 outpatients in the clinic of respiratory department of Anzhen Hospital from Jan 2006 and Dec 2006 were divided as trial group （ n = 86） and control group （ n = 87 ）. The patients in the control group were given general treatment, and those in the trial group received additional individuation thera- py of education, management, rehabilitation of disease, and psychological intervention. Before and 3 months after the treatment, all the patients were given pulmonary function test and Quality of Life （QOL） questionnaire surveys [ the Nottingham health profile （NHP） for university questionnaire, and Seattle Obstructive Lung Disease Questionnaire （SOLDQ） for disease - special questionnaire]. And the patients＇ acute episodes of COPD during the course of treatment were also recorded. Results The inner consistent coefficients of the two - QOL questionnaires were 0. 85 and 0. 77 respectively. The results of constructive validity analysis of the two - QOL questionnaires showed statistic correlation to deferent extent （ P 〈 0.01 ）. The QOL scores before and after treatment in the trial group were significantly different （ P 〈 0.05 ）, while those in the control group were no significantly different （ P 〉 0.05 ）. However in pulmonary function after and before therapy there was no significantly different in both groups （ P 〉 0. 05 ）. Conclusion The Individuation therapy can improve the quality of life for patients with chronic obstructive pulmonary disease.